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Author: Sabrina Lazzarato  Is Psychodynamic Psychotherapy Making a Comeback? Psychodynamic psychotherapy has long been associated with Freud and Jung’s ideas which once reigned as the primary direction for psychotherapy. For decades, psychodynamic theory and practice has faded from public favor and clinical practice as it has been labeled as unscientific, outdated, and inefficient. However, psychodynamic therapy may be having a revival. In Mauricio Cortina’s 2010 article “The Future of Psychodynamic Psychotherapy,” he explores the reasons why the field fell out of favor as well as how it is regaining relevance in modern mental health care, and more recent studies and meta-analyses seem to support his conclusion.
Why Did it Fall Out of Favor? First, Cortina outlines two major reasons for the decline of psychodynamic psychotherapy: theoretical infighting and resistance to empirical testing. In terms of theoretical infighting, psychodynamic schools fractured into competing camps (e.g., Freudians, Jungians, ego psychologists) instead of evolving collaboratively. This intellectual infighting confused the public, alienated clinicians, and undermined the field’s coherence. Additionally, while other modalities (e.g., cognitive behavioral therapy) embraced empirical research and controlled trials, many psychodynamic theorists resisted quantifying and operationalizing their concepts. The reluctance to engage with modern scientific standards caused the therapy to be viewed as unmeasurable, unproven, and ultimately outdated. Why is it Coming Back? So how could one argue that psychodynamic therapy is now making a return? Cortina identifies several key forces behind the resurgence. The first is neuroscience validation. Recent discoveries in affective neuroscience support long-held psychodynamic concepts such as empathy, unconscious conflict, and emotional attunement now all have biological backing. The second is further attachment and developmental research. Decades of empirical work in attachment theory (e.g., by Ainsworth, Bowlby, and Sroufe) have shown that early relationships profoundly change personality and emotional resilience, which validates core psychodynamic principles. The third is that defense mechanisms have been revisited in contemporary research. Defense mechanisms were originally introduced by Freud and are now being scientifically studied and have been linked with physiological stress responses and adaptive functioning across the lifespan. The final reason, and perhaps most important step towards the revival of psychodynamic psychotherapy, is evidence-based practice. Recent meta-analyses and randomized control trials have shown that psychodynamic therapy is effective, especially for depression, anxiety, personality disorders, and somatic symptom disorders. The Evidence: Recent large-scale reviews and meta-analyses offer evidence of psychodynamic psychotherapy’s effectiveness across a range of mental health conditions and populations. A 2017 meta-analysis conducted by Steinert et al. analyzed 23 randomized controlled trials comparing psychodynamic therapy with CBT or other empirically supported treatments. The results identified that psychodynamic therapy was found to be statistically equivalent in effectiveness. When reaching the post-treatment phase, the effect size was g = -0.15 and at follow-up had narrowed to g = -0.05, which indicates lasting therapeutic benefits that match the outcomes of other empirically based treatments (Steinert et al., 2017). Beyond reducing symptoms of disorders, psychodynamic therapy has also been shown to have a reduction effect for patients at risk for suicide or self-injury (Briggs et al., 2019). A 2019 systematic review and meta-analysis (Briggs et al.) evaluated 17 studies that involved patients at risk for suicide or self-injury. Researchers found that psychodynamic and psychoanalytic therapies significantly reduced suicide attempts and improved psychosocial functioning and quality of life. Psychodynamic therapy is also showing promise with younger populations. In 2024, Trottal et al. published a meta-analysis examining the effectiveness of psychodynamic psychotherapy for young adults (ages 18 to 25). This age group is often under-represented in psychotherapy research. The analysis included 21 studies and found large effect sizes for symptom reduction. When compared to active treatments like CBT, psychodynamic psychotherapy produced equivalent outcomes, further confirming its relevance for treating anxiety, depression, and relational distress in emerging adulthood. What's Different About Psychodynamic Therapy Today? Psychodynamic therapy has undergone significant modernization, and it is not the same as when Freud first lectured or when Jung first established theories. The field has begun to utilize short-term structured formats that make the treatment both more accessible and affordable. It has integrated with neuroscience and cognitive science, which allows for a holistic brain-based approach. Psychodynamic therapy today also uses outcome tracking and process research embedded in many training programs to define clients’ progress. Additionally, it has less dogma and is more centered on dialogue. Modern practitioners have become less focused on theoretical purity and more on what actually works for people in real clinical settings. The Future Although Cortina's article was written in 2010, it is remarkably future-oriented. He recognized that for psychodynamic therapy to survive, it needed to embrace scientific inquiry, interdisciplinary collaboration, and actual clinical and empirical effectiveness. Today’s research shows that this is exactly what’s happening. With support from meta-analyses, studies, and outcome data, psychodynamic psychotherapy is reclaiming its seat at the table through clinical innovation. Overall, the resurgence of psychodynamic psychotherapy isn't a return to the past, but rather a progression towards a more integrative, evidence-based, informed future for mental health care. Works Cited Briggs, S., Netuveli, G., Gould, N., Gkaravella, A., Gluckman, N. S., Kangogyere, P., Farr, R., Goldblatt, M. J., & Lindner, R. (2019). The effectiveness of psychoanalytic/psychodynamic psychotherapy for reducing suicide attempts and self-harm: systematic review and meta-analysis. The British journal of psychiatry : the journal of mental science, 214(6), 320–328. https://doi.org/10.1192/bjp.2019.33 Cortina M. (2010). The future of psychodynamic psychotherapy. Psychiatry, 73(1), 43–56. https://doi.org/10.1521/psyc.2010.73.1.43 Steinert, C., Munder, T., Rabung, S., Hoyer, J., & Leichsenring, F. (2017). Psychodynamic Therapy: As Efficacious as Other Empirically Supported Treatments? A Meta-Analysis Testing Equivalence of Outcomes. The American journal of psychiatry, 174(10), 943–953. https://doi.org/10.1176/appi.ajp.2017.17010057 Trotta, A., Gerber, A. J., Rost, F., Robertson, S., Shmueli, A., & Perelberg, R. J. (2024). The efficacy of psychodynamic psychotherapy for young adults: a systematic review and meta-analysis. Frontiers in psychology, 15, 1366032. https://doi.org/10.3389/fpsyg.2024.1366032
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Author: Laura Petracek  As human beings, we all experience negative thoughts from time to time. It's natural to have occasional doubts, fears, and worries. However, when negative thoughts become pervasive, they can have a significant impact on our mental health and well-being.
Ignoring negative thoughts may seem like a good strategy for managing them, but in reality, it can actually make things worse. When we ignore negative thoughts, we're essentially giving them power over us. We're allowing them to fester and grow, unchecked by any kind of challenge or inquiry. On the other hand, when we challenge negative thoughts, we take back control. We begin to question their validity and explore alternative perspectives. By doing so, we're able to reduce their power over us and cultivate a more positive mindset. So why is it important to challenge negative thoughts instead of ignoring them? Here are a few reasons:
It's important to challenge our negative thoughts rather than ignoring them. By doing so, we can reduce stress and anxiety, develop a more accurate and balanced perspective, and cultivate a more positive mindset. If you're struggling with negative thoughts, try to approach them with curiosity and a willingness to explore alternative perspectives. With practice, you'll find that challenging negative thoughts becomes easier and more natural over time. About the Author: Laura Petracek, Ph.D., LCSW, is the author of The DBT Workbook for Alcohol and Drug Addiction and The Anger Workbook for Women. Online: Personal Website, Facebook, LinkedIn, Instagram |
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